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This page will provide you with information about inserting a tension-free vaginal tape for stress incontinence. For further details, you should speak to your consultant.
Stress incontinence is when urine leaks from your bladder, usually caused when pressure (stress) is placed on it. This pressure is commonly caused by exercise, laughing, coughing or sneezing. Stress incontinence can also be due to weak pelvic-floor muscles. Often, this weakness is caused by the muscles being stretched or damaged during childbirth. Occasionally, stress incontinence can be caused or worsened by a weakness in the urinary sphincter. This is often made worse if you are overweight or smoke, and will likely continue to get worse with age.
After inserting a tension-free vaginal tape (TVT), urine should no longer leak from your bladder in an uncontrolled way. The mesh tape is placed under a sagging urethra (the tube that carries urine from your bladder) like a sling to help keep it closed under stress.
One common alternative to a TVT is a transobturator tape. This requires an operation similar to inserting a TVT, but the tape comes up out of your thigh crease rather than behind your pubic bone. Other surgical procedures include Burch colposuspension (lifting the front wall of your vagina and attaching it with stitches onto a ligament behind your pubic bone) or needle suspension (a suture from the abdominal wall through the tissue beside the urethra and then back to the abdominal wall). However, these are larger operations than inserting a TVT but are usually no more effective. Non-surgical options include pelvic floor exercises, electrical stimulation (to help pelvic floor muscles strengthen), incontinence devices and bladder neck bulking (an injection to reduce the size of the urethra).
Your surgeon will make two small incisions on the lower part of your abdomen and another small cut on your vagina just below your urethra (see figure 1).
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The surgeons will then pass a needle, with the mesh tape, from one side of your urethra and up through one of the cuts made on your abdomen. Your doctor will pass the needle, with the tape, from the other side of your urethra and up through the other cut on your abdomen. The operation is usually performed under a general anaesthetic. The operation usually takes about 30 minutes.
Any risks or complications will be discussed in advance of your treatment with your expert consultant.
You should be allowed home after you have passed urine in the normal way, usually later on the same day or the day after. Some women may need to use a catheter to assist them emptying their bladder immediately after the surgery, and occasionally for a week or so after. Depending on your type of work, you may be able to return to work after three to four days. However, most women need to wait two to four weeks before resuming work. Your doctor will likely tell you not to undertake any manual work for a while, such as heavy lifting. Sexual intercourse should be avoided for 4 weeks after the operation. Continuing your pelvic-floor exercises can help prevent the incontinence from coming back and reduce the risk of a prolapse. If you have any questions, you should ask your consultant.
References: EIDO Healthcare Limited - The operation information on this website is produced using information from EIDO Healthcare Ltd and is licensed by Aspen Healthcare.
The information should not replace advice that your relevant health professional would give you.